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The Outreach Program and the New Clinic

August 29, 2016

The New Clinic (pictured): The Outreach Program covers 5 provinces of the Northeast Thailand and sees approximately 100 families. It provides for the primary needs of families affected by HIV/AIDS by supplying medicines, food and money for educating the children. As well as the home visits, the Outreach Program has a clinic once a week where it provides primary care for people living with and affected by HIV/AIDS. Once a month the Outreach Team has an activity day in Don Wai where the families and children are picked up and driven to Don Wai for lunch, writing letters to their sponsors and general support.

While the Nongkhai Provincial Hospital is 20 km from Don Wai and provides basic care, often the very ill patients who are bought to the clinic by relatives need to be transferred to the university hospital in Khon Kaen, a 2 hour drive away, for more comprehensive diagnostic assessment and treatment. The Outreach Program provides transport as most people are too poor or sick to be able to get there themselves. We also accompany them to see the doctor, and translate treatment information into easy to understand language.

The Outreach Program visits families in the villages who are living with or have been affected by HIV/AIDS. The aim of these visits is to assess the living conditions and the health of families, they are sometimes incredibly poor and their houses are nothing more that 2 walls, a rotten roof and a dirt floor. If funds allow, a new home is built, using local tradesmen and involving relatives and neighbors. The Outreach Program also supports children who are living with HIV/AIDS, and are cared for by their grandmothers, the mothers having already died of AIDS. Education about how and when to take Antiretroviral Therapy (ART) medication correctly and helping them attend follow up visits at the hospital is essential.

A Success Story

At the beginning of 2009 a young man names Ka Jon arrived in the back of a pickup truck, his face hidden inside a woolen balaclava. He had been working down in Bangkok in construction and had found himself losing weight and getting weaker. He came back home to his village and his parents’ house up here in north east Thailand. He had been sending money back to them every month for them to survive, as they make Thai sweets in their home and sell them at the local market earning hardly enough money to live on. After almost 12 months of slow deterioration KaJon’s parents took him to the local hospital. There they did an HIV test and found him to be HIV positive, and diagnosed him with TB. The hospital gave him the appropriate anti TB medications and sent him home with no further follow up. His mother bought him here to the Friday morning clinic a few weeks later. His face was covered in black pustules and scabs, his legs and arms were bleeding with skin peeling off them, he had oral thrush, weight loss, a cough and fever. He was treated at the clinic with dressings and symptom control of his fever, thrush and cough. Then he was taken back to the hospital for further investigations. The following week his mother bought him back to the clinic much more deteriorated, with more lesions on his extremities, and his face black and covered with more pustules and scabs. He was in constant pain and discomfort. After contacting the local hospital where he had been, they refused to have him back, so the provincial hospital was contacted and they agreed to admit him there for a night, and then refer him to the university hospital – 2 hours drive away. The next day we picked him up and drove him to the university hospital, with his father who stayed with him and provided all his basic care for the next 3 weeks of his admission. He was diagnosed and treated for AIDS, TB, histoplasmosis - a severe end stage fungal infection and a staph infection.

 
KaJon in January 2009(left) and KaJon in June 2009 (right)

Now he is back at home with his parents with a prognosis that is unclear. But he has gone from a young man disfigured, shunned and totally dependant on others to a man who is slowly becoming more independent and who has hope for the future again.

 


KaJon at home October 2009

Cost

In 2008 the cost of the Outreach Program was 824,656 THB / US$27,785 / EURO 16,941. This includes food, medications, diagnostic tests, hospital expenses, transportation, fuel, communications, and assistance to families affected by HIV. This cost is covered entirely by donations.

The New Clinic

Previously:


Rectory Clinic

The clinic was previously run out of a small room under the rectory and next to the office at Don Wai. Every Friday morning from 5 people to 20 people turn up. People come at all stages of HIV /AIDS. Often young men, who have been working in Bangkok, come back home as they progressively begin to show signs of HIV infection – loss of weight, tiredness, skin infections and are no longer able to continue their jobs. Some of them have tested positive for HIV, others have not been tested at all. They are often the only source of income for their families, and it is their families or neighbors who tell them about the clinic and bring them here. Referral and accompanying people to the hospital to access appropriate services and to begin their treatment for HIV is one of the many responsibilities of the Outreach Program. Monitoring these same people at their weekly clinic visits to ensure they are taking the vital ART medications correctly and assessing them for any new symptoms or side effects, providing vitamins to improve their nutritional status and treating basic infections and injuries are also part of the Outreach Program’s goals. People with symptoms of TB and meningitis have presented to the clinic and are then referred or taken directly to hospital. Just as important as the clinical care is the sense of community and camaraderie that gathering at the clinic provides. This time allows these marginalized people to get to know and support one another. From this network, word goes out when someone in the surrounding villages is sick and suspected of having HIV and they are directed to the clinic.

 

Now:


Miss Dottie and Man U in the quarantine bedroom

Thanks to the generosity and the hard work of friends from The Netherlands, the Outreach Program can provide its services from a brand new Clinic. Ben and Angelique Ummels (www.vriendenvansarnelli.nl) are regular visitors and supporters of Sarnelli House, and in 2008 they bought their friends Leon and Henriette Castermans for a visit. When they returned home they did some serious fundraising and raised enough money to build a new clinic on land opposite Sarnelli House. The clinic has a separate medicine room, a bedroom with 3 beds for children who need to be isolated from the other children if they have TB or chicken pox, and a large open clinic area to treat people. There are outside toilets and enough cement laid for people to park their motorbikes.

Thanks also to the generosity of The British Community in Thailand Foundation for the Needy, The Bangkok St George’s Society and the British Women’s Group in Bangkok; the clinic was able to be furnished.

On the 25th September, 2009, 11 people came for treatment and support, and were impressed and grateful for the new clinic. We are now waiting for the official opening when Leon and Henriette can join us as well as Ben and Angelique and where we can try and thank them for their hard work and generosity in making a dream come true and allowing the Outreach Program to better serve the people of the area.

 

Kate

October 2009

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